Project 2025 Housing Chapter Uses EMTALA, ACA, and Hyde Amendments to Restrict Abortion Access
Project 2025 HHS chapter calls for reinstating Trump-era ACA abortion separate payment rules, auditing Hyde compliance to restrict abortion access, rescinding EMTALA abortion guidance, and codifying Hyde and Weldon amendments—directly undermining reproductive autonomy and endangering patients in emergency settings.
The Project 2025 plan for HHS is a coordinated assault on abortion access, hiding behind legal technicalities and bureaucratic audits. By reinstating strict separate payment requirements under ACA Section 1303, it would make abortion coverage effectively unaffordable and inaccessible for millions enrolled in qualified health plans. The call for a Hyde compliance audit, targeting Biden's post-Dobbs executive actions, is designed to eliminate any federal funding pathway for abortion care—even in cases of rape, incest, or life endangerment. These aren't fiscal oversight measures; they are barriers designed to reduce abortion access to the point of nonexistence.
The most dangerous proposal is rescinding the July 2022 EMTALA guidance that requires hospitals to provide abortion care when necessary to stabilize emergency medical conditions. This guidance is a lifeline in states with near-total abortion bans; without it, patients experiencing miscarriages, ectopic pregnancies, or other life-threatening complications can be turned away. Project 2025 also revives Trump-era rules that threaten Medicare funding over 'born-alive' claims and pushes to codify the Hyde and Weldon amendments permanently. The Section 1557 rollback targeting gender identity and abortion-related care further compounds harm for LGBTQ+ patients and pregnant people.
In contrast, a just HHS would expand reproductive healthcare access by enforcing EMTALA protections, reversing Hyde-imposed funding restrictions, and strengthening Section 1557 nondiscrimination rules. Federal policy should guarantee that every person—regardless of income, location, or identity—can access the full range of reproductive health services, including abortion. We need to codify abortion rights into law and ensure that patients, not politicians, make decisions about their bodies.
The humanitarian alternative
Congress should pass the Women's Health Protection Act to codify abortion rights nationally and the EACH Act to repeal Hyde restrictions, while HHS strengthens EMTALA enforcement and Section 1557 protections for all reproductive care.
Original source — excerpted
project2025 Project 2025 ch. 15: Department of Housing and Urban Development (pp 506-508)"— 473 — Department of Health and Human Services l Rewrite the ACA abortion separate payment regulation. Section 1303 of Obamacare requires that insurers collect a separate payment for certain abortion coverage in qualified health plans that are approved to be sold on exchanges and that they keep those separate payments in separate accounts that are used only to pay for elective abortion services. Neither the letter nor the spirit of the law was enforced under President Obama, and a Trump- era regulation sought to correct this problem. The Biden HHS rescinded this regulation to allow insurance companies once again—contrary to the law—to collect combined payments for what are clearly required to be separate payments for elective abortion coverage. “Separate” does not mean “together.” HHS should reinstate a Trump Administration regulation and enforce what the plain text of Section 1303 requires. That regulation should be further improved by requiring CMS to ensure that consumers pay truly separate charges for abortion coverage. l Audit Hyde Amendment compliance. HHS should undertake a full audit to determine compliance or noncompliance with the Hyde amendment and sim…"